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SOUTHDALE PERIODONTICS, PLLC
NPI 1134547730
Dentist - Periodontics in Edina, MN

Active since April 01, 2014
6545 FRANCE AVE S, SUITE 190, EDINA, MN 55435(952) 922-6949(952) 922-9287 Get Directions Write a Review

NPPES record last updated: April 1, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southdale Periodontics, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHDALE PERIODONTICS, PLLC (NPI 1134547730) is a healthcare organization registered as a periodontics in Edina, Minnesota and active in the NPI registry since April 2014. The organization lists Russell Allen Dylla, Owner, as its authorized official.

NPPES Registry Identity

NPI1134547730
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameSOUTHDALE PERIODONTICS, PLLC
Location Address6545 FRANCE AVE S, SUITE 190Edina, MN 55435-2131
Mailing Address6545 France Ave S, Suite 190Edina, MN 55435-2131 · (952) 922-6949 · Fax (952) 922-9287
Phone(952) 922-6949
Fax(952) 922-9287
Organization SubpartNo
Authorized OfficialRussell Allen DyllaOwner · (952) 922-6949
Enumeration DateApril 1, 2014
✔ NPI 1134547730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in MN · D12016
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
6545 FRANCE AVE S, Edina, MN 55435
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS STEALEY MD
Pediatrics
6545 FRANCE AVE S, SUITE 400
EDINA, MN 55435
Hennepin County (952) 920-9191
DR. MICHELE ANN REYNOLDS D.D.S.,M.S.
Dentist (Endodontics)
6545 FRANCE AVE S, SUITE 665 SOUTHDALE MEDICAL BUILDING
EDINA, MN 55435
Hennepin County (952) 927-8694
MRS. AMY MICHELLE BOYDEN-HOEKSTRA P.T.
Physical Therapist
6545 FRANCE AVE S, SUITE 373
EDINA, MN 55435
Hennepin County (952) 835-4512
VICKI I BUTH CNP
Nurse Practitioner (Obstetrics & Gynecology)
6545 FRANCE AVE S, STE 540
EDINA, MN 55435
Hennepin County (952) 927-4045
MICHELE R O'BRIEN CNS
Clinical Nurse Specialist (Adult Health)
6545 FRANCE AVE S, STE 210
EDINA, MN 55435
Hennepin County (952) 928-2900
DR. DAVID JOHN CLAY DDS MS
Dentist (Prosthodontics)
6545 FRANCE AVE S, SUITE 680
EDINA, MN 55435
Hennepin County (952) 922-5326
DR. MARY ELIZABETH JOHNSON D.D.S.
Dentist (Endodontics)
6545 FRANCE AVE S, SUITE 665
EDINA, MN 55435
Hennepin County (952) 927-8694
STEPHANIE LYNAE GULBRANSON
Nurse Practitioner (Family)
6545 FRANCE AVE S
EDINA, MN 55435
Hennepin County (952) 836-3695

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southdale Periodontics, PLLC's NPI number?

The NPI number for Southdale Periodontics, PLLC is 1134547730. It was assigned to this organization in the NPPES registry on April 1, 2014.

Where is Southdale Periodontics, PLLC located?

Southdale Periodontics, PLLC is located at 6545 France Ave S Suite 190, Edina, MN 55435. The listed phone number is (952) 922-6949.

What is Southdale Periodontics, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Southdale Periodontics, PLLC was last updated on April 1, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.